Provider Demographics
NPI:1154342756
Name:NAUGLE, TORY DAWSON (DC)
Entity type:Individual
Prefix:DR
First Name:TORY
Middle Name:DAWSON
Last Name:NAUGLE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2460 NW TROOST ST
Mailing Address - Street 2:
Mailing Address - City:ROSEBURG
Mailing Address - State:OR
Mailing Address - Zip Code:97471-7704
Mailing Address - Country:US
Mailing Address - Phone:541-673-0190
Mailing Address - Fax:541-957-9410
Practice Address - Street 1:2355 NW STEWART PKWY
Practice Address - Street 2:
Practice Address - City:ROSEBURG
Practice Address - State:OR
Practice Address - Zip Code:97470-5653
Practice Address - Country:US
Practice Address - Phone:541-673-0190
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-21
Last Update Date:2017-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR27-3553111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORV09125Medicare UPIN